PURPOSE: To evaluate the radiologic and clinical results of treatment of the Shatzker type 6 tibia plateau fracture using the lateral and posteromedial dual incision approach and dual plating. MATERIALS AND METHODS: Twelve cases in eleven patients of Shatzker type 6 tibia plateau fracture which has been treated using the lateral and posteromedial dual incision approach and dual plating were analyzed with an average follow-up of 16 months. Times to union, alignment and reduction loss on radiograph and postoperative clinical outcome with checking the range of motion of the knee joint, Knee Society Score and UCLA activity scale were analyzed and evaluated. RESULTS: In all cases, bony union was obtained in an average fifteen weeks after the operation, and there was no reduction loss. The arc of motion of the knee joint at the latest follow-up was 132 degrees on average. Average of Knee Society Score was 85 and UCLA activity scale was decreased from 9.6 points preoperatively to 5.7 points postoperatively. CONCLUSION: The treatment of Shatzker type 6 tibia plateau fracture using the lateral and posteromedial dual approach and dual plating have shown clinically preferable results of excellent recovery of joint motion and good knee society score by early range of motion exercise after firm fixation. However, it was high energy injury, so the sports activity of patients was significantly decreased.
Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Range of Motion, Articular ; Sports ; Tibia

We have treated thirteen complex plateau fractures involving both condyles with one of the following conditions with the use of the combined anterior and posterior approaches in a modified supine position. Associated PCL avulsion fracture, displacement of major fracture plane dominantly at the back, large coronal fracture fragment involving medial or lateral condyles. A patient is placed on an operation table in supine position with a bump under the contralateral buttock. The well leg is placed in a lithotomy position and the injured leg is placed over a sterilized Mayo stand separately. For the posterior approach the table was tilt toward the injured side with the hip abducted and rotated externally. With a modified patient's positioning we were able to use combined anterior and posterior approaches simultaneously for the management of certain complex plateau fractures without changing the draping.
Buttocks ; Hip ; Humans ; Leg ; Operating Tables ; Patient Positioning* ; Supine Position

PURPOSE: To evaluate the treatment outcomes of the modified extension block technique for bony mallet finger. MATERIALS AND METHODS: This study included 16 patients who had been treated with the modified extension block technique for bony mallet finger from December 2002 to January 2004. The average duration of follow up was 13 (12~17) months. The indication of operation was the presence of a large bony fragment invading more than 1/3 of the articular surface or the palmar subluxation in the distal interphalangeal joint. RESULTS: The average extension lag was 2.3 degrees, and the range of motion of the distal interphalangeal joint was 68.8 degrees. Radiograph showed bony union state in all cases. By the Crawford's evaluation criteria, 12 cases (75%) was excellent or good. Postoperative complications occurred in 3 cases, which were reduction loss within postoperative 2 weeks in 2 cases and mild pain with motion in 1 case. CONCLUSION: The modified extension block technique is a easy and simple method. It shows a good result without complications from skin incision. So, it seems a useful method for bony mallet finger.
Fingers* ; Follow-Up Studies ; Humans ; Joints ; Postoperative Complications ; Range of Motion, Articular ; Skin

PURPOSE: We evaluated the syndesmosis instability associated with Weber type B lateral malleolar fractures. MATERIALS AND METHODS: Eighty one Weber type B lateral malleolar fractures were evaluated and classified according to the radiologic criteria. Syndesmosis instability was checked with a hook test during operation. The radiological and clinical results were assessed. RESULTS: Twenty two cases were associated with a widening of the distal tibiofibular distance. Sixteen (73%) had syndesmosis instability confirmed with a hook test and were fixed with a syndesmotic screw. Eight (66%) out of 12 Wagstaffe fractures were fixed with a syndesmotic screw due to the instability. The distal tibiofibular distance was 7.4+/-2.4 mm, 4.6+/-1.9 mm and 4.9+/-1.9 mm preoperatively, postoperatively, and at the final follow up, respectively. All cases achieved union and good clinical results with more than 85 on the AOFAS score were obtained. CONCLUSION: Weber type B lateral malleolar fractures can be associated with a syndesmosis injury. An intraoperative hook test should be carried out for accurate diagnosis. Considerable attention needs to be paid to Wagsteffe fractures, because of the high probability of combining syndesmosis instability.
Animals ; Ankle ; Follow-Up Studies